Provider Demographics
NPI:1275591760
Name:WHEATLAND HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:WHEATLAND HEALTH SERVICES, LLC
Other - Org Name:ANGELS CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-469-6739
Mailing Address - Street 1:2301 HIGHWAY 1187
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6124
Mailing Address - Country:US
Mailing Address - Phone:817-469-6739
Mailing Address - Fax:817-801-3486
Practice Address - Street 1:11 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-1853
Practice Address - Country:US
Practice Address - Phone:620-432-0025
Practice Address - Fax:620-432-0113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA103005251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
178060Medicare Oscar/Certification